Prevalence of untreated second canal in the mesiobuccal root of maxillary molars and its association with apical periodontitis: A cone beam computed tomography study

Abstract

This study aimed to evaluate the prevalence of mesiobuccal 2(MB2) canals not located/treated in maxillary molars and correlated their non-treatment with the presence of periradicular lesion. The study was conducted on 180 cone beam computed tomography (CBCT) scans. The 180 examinations added up to 210 teeth analyzed (140 maxillary first molars and 70 maxillary second molars). The presence of non-located/treated MB2 canals and periapical lesions in the mesiobucal(MB) root was identified by observation of the axial and subsequently of sagittal and coronal slices. Among the 210 teeth evaluated, 91.4% (n=192) had MB2 canal, while 8.6% (n=18) did not have this canal. In the first molars with presence of MB2 (n=133), periapical lesion was observed in 85.0% (n=113). Among the second molars with presence of MB2 (n=59), periapical lesion was observed in 72.9% (n=43). The presence of periapical lesion in the MB root was related to the non-location/treatment of the MB2 canal and was higher when it was an independent canal.

Prevalence of MB2 canals in maxillary molars using different assessment methods: ex vivo analysis

“…The agreement analysis in the present study demonstrated a slight concordance of the digital radiography in relation to CBCT, being the superiority of this last one proved by a greater detection of MB2. These findings are supported with results from previous studies comparing the accuracy of this and other methods with CBCT (Machado et al, 2021;Pereira et al, 2021;Ratanajirasut et al, 2018;Torres et al, 2015). Thus, CBCT can be considered a great and reliable option for routine clinical use.…”

“…The Figure 1 shows images highlighting the absence or presence of MB2 canal, by using some method of assessment of this study. The variation in the morphology of the root canal system in multiradicular teeth remains challenge in Endodontics (Machado et al, 2021;Ordinola-Zapata et al, 2017;Pereira et al, 2021). With technological advancement the CBCT, DR and visual magnification are becoming a reality in successful endodontic treatment, as they allow considerable advantages in terms of quality, efficiency, and security to clinical and specialist.…”

“…Particular attention has been given to the MB root, whose flattening in the mesiolingual direction provides a high prevalence of two canals. In the literature, the frequency of MB2 in maxillary molars ranges from 25% to 100% (Ahmed et al, 2017;Buhrley et al, 2002;Gupta et al, 2017;Pereira et al, 2021;Wolf et al, 2017).…”

“…The knowledge of the anatomy of root canal systems is essential to endodontic treatment successful (Machado et al, 2021;Souza Júnior et al, 2021). Complex dental anatomy represents challenge to endodontists, and one of the most likely causes of persistence or development of periradicular disease, when endodontic treatment is failure to locate, clean, shape, and obturate the root canals (Ahmad et al, 2014;Baratto-Filho et al, 2009;Pereira et al, 2021). In this context, the maxillary molars have complex internal anatomy specially because the high prevalence of three roots and four canals in these teeth.…”

“…In this context, the maxillary molars have complex internal anatomy specially because the high prevalence of three roots and four canals in these teeth. A second canal is usually found in the mesiobuccal root (MB), named MB2 (Gupta et al, 2017;Pereira et al, 2021;Wu et al, 2017).…”